Submit a Request
Select the type of issue
Please Select
Employment Claims
Housing
DPW
COVID-19 (site, vaccine, testing)
Legislation
Public Safety
Health
Taxes
DDOT
Small Businesses
DMV
Education
Human Rights Violation
Construction Enforcement
Other
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Ward
Please Select
Ward 1
Ward 2
Ward 3
Ward 4
Ward 5
Ward 6
Ward 7
Ward 8
Have you contacted your ward Councilmember?
Please Select
Yes
No
Other
(it is ok if you have not)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nature of the problem
Does it require follow up?
Yes
No
Submit
Should be Empty: